A Summation Analysis of Compliance and Complications of Compression Hosiery for Patients with Chronic Venous Disease or Post-thrombotic Syndrome

Kankam, Hadyn; Lim, Chung Sim; Fiorentino, Francesca; Davies, Alun H.; Gohel, Manjit

doi:10.1016/j.ejvs.2017.11.025

Cited by 57 publications

(49 citation statements)

References 54 publications

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“…Aversive aspects of ECSs were the most frequently cited reasons for nondaily use of ECSs, followed by patient behavior‐related reasons (75.3% and 21.2%, respectively, at 1‐month visit). This finding is in line with a summation analysis that evaluated compression stocking compliance; among the 18 studies reviewed that described reasons for noncompliance, all cited either excessive tightness, pain, or intolerance to heat with use of stockings …”

Section: Discussioncontrasting

confidence: 99%

“…Factors that have previously been reported to influence compliance with ECSs include degree of compression, history of prior DVT, and, in patients with chronic venous insufficiency, time since diagnosis. In a recent review that included compliance information on 8104 patients who were prescribed ECSs, good compliance was reported in 66.2% of these patients, and stockings <25 mm Hg were associated with better compliance (77% vs. 64.6%) . Lesser degrees of compression may encourage greater compliance; however, in one study examining ECSs for secondary prevention of venous ulcers, ECSs with lower compression strength were associated with greater recurrence of venous ulcers .…”

Section: Discussionmentioning

confidence: 85%

“…The reasons for and predictors of noncompliance observed in the SOX Trial are specifically applicable to patients with a first symptomatic DVT who participated in a trial of the use of stockings for the purpose of prevention of PTS. However, compliance rates of use of ECSs have been reported to be similar whether prescribed for prevention of PTS or treatment of venous insufficiency . Therefore, our results may be generalizable to patients using ECSs for treatment of acute DVT symptoms or chronic venous insufficiency, including PTS.…”

Section: Discussionmentioning

confidence: 99%

“…Elastic compression stockings (ECSs) reduce venous hypertension and venous stasis in the lower extremities, and are frequently used to prevent and treat venous insufficiency, a prevalent and costly chronic condition . However, many patients prescribed ECSs do not fill their prescription or fill their prescription but do not wear their ECSs . Thus, lack of compliance might be an important limitation to achieving optimal effectiveness of ECSs.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 However, many patients prescribed ECSs do not fill their prescription 3 or fill their prescription but do not wear their ECSs. 4 Thus, lack of compliance might be an important limitation to achieving optimal effectiveness of ECSs.…”

Section: Introductionmentioning

confidence: 99%

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Patient‐reported reasons for and predictors of noncompliance with compression stockings in a randomized trial of stockings to prevent postthrombotic syndrome

Dawson

Akaberi

Galanaud

et al. 2020

Research and Practice in Thrombosis and Haemostasis

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Introduction Elastic compression stockings (ECSs) are used to treat symptoms of venous insufficiency. However, lack of patient compliance can limit their effectiveness. In a secondary analysis of the SOX Trial, a randomized trial of active vs. placebo ECSs worn for 2 years to prevent postthrombotic syndrome after deep vein thrombosis, we aimed to describe patient‐reported reasons for nondaily use of ECS and to identify predictors of noncompliance during follow‐up. Methods At each follow‐up visit of the SOX Trial, patients were asked how many days per week they wore study stockings, and if not worn daily, to specify the reason(s). Reasons for nondaily use of ECSs were tabulated. Multiple logistic regression modeling was used to identify predictors of stocking noncompliance during follow‐up (defined as use <3 days per week). Results Among the 776 patients who attended at least 1 follow‐up visit, daily use of stockings at each visit was similar in the active and placebo ECS groups. Reasons for nondaily use of stockings was most frequently related to aversive aspects of stockings (~three‐fourths of patients) and less often related to patient behaviors (~one‐fourth of patients). In multivariate analyses, behavior‐related and aversive aspect–related reasons for nondaily use of ECSs at the 1‐month visit were significant predictors of noncompliance during follow‐up (odds ratio [OR] = 4.41 [95% confidence interval, 2.12‐9.17] and OR = 3.99 [2.62‐6.08], respectively). Conclusions Aversive aspects of ECSs and patient behaviors are important reasons for noncompliance. Improving the appeal and tolerability of ECS and education directed at modifying patient behaviors may improve compliance.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patient‐reported reasons for and predictors of noncompliance with compression stockings in a randomized trial of stockings to prevent postthrombotic syndrome

Dawson

Akaberi

Galanaud

et al. 2020

Research and Practice in Thrombosis and Haemostasis

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Compression stockings to prevent postthrombotic syndrome: Literature overview and presentation of the CELEST trial

Galanaud

Genty-Vermorel

Rolland

et al. 2020

Research and Practice in Thrombosis and Haemostasis

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Postthrombotic syndrome (PTS) is a burdensome and costly complication of deep vein thrombosis (DVT) that develops in 20%‐40% of patients within 2 years after proximal DVT. In the absence of effective curative treatment, management of PTS relies on its prevention after DVT. The effectiveness of elastic compression stockings (ECS) to prevent PTS is uncertain. We present an overview of published studies assessing the efficacy of ECS to prevent PTS and present the protocol for the CELEST clinical trial. While previous open‐label randomized trials have reported a 50% risk reduction in PTS in patients treated with >30 mm Hg ankle pressure ECS, a large double‐blind trial reported no effect of ECS. We discuss the main potential limitations of these trials, including a placebo effect and suboptimal compliance to ECS. We present the protocol of the CELEST double‐blind randomized trial comparing 2 years of high strength (ankle pressure 35 mm Hg) versus lower strength (ankle pressure 25 mm Hg) ECS in the prevention of PTS after a first acute symptomatic, unilateral, proximal DVT. The use of lower‐strength ECS than that used in previous studies should favor compliance. CELEST may provide important evidence about the efficacy of ECS in the prevention of PTS after DVT. The results will be interpreted in the light of results from recent clinical trials assessing ECS for PTS prevention that reported that the duration of ECS use should be tailored to the individual, if ECS are efficacious in the prevention of PTS.

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Varicosis—Current treatment concepts

Lisii,

Heckenkamp

2024

Chirurgie

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A Summation Analysis of Compliance and Complications of Compression Hosiery for Patients with Chronic Venous Disease or Post-thrombotic Syndrome

Cited by 57 publications

References 54 publications

Patient‐reported reasons for and predictors of noncompliance with compression stockings in a randomized trial of stockings to prevent postthrombotic syndrome

Patient‐reported reasons for and predictors of noncompliance with compression stockings in a randomized trial of stockings to prevent postthrombotic syndrome

Compression stockings to prevent postthrombotic syndrome: Literature overview and presentation of the CELEST trial

Varicosis—Current treatment concepts

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